Table 1

Potentially beneficial actions of insulin in critical illness

Less (stress) hyperglycaemia by 'overcoming' insulin resistance, and therefore better antimicrobial defence and wound healing

Stimulation of glucose uptake/glycolysis, pyruvate dehydrogenase and energy production

Anti-inflammatory properties, such as less oxygen radical formation

Suppression of insulin-like growth factor (IGF)-I-binding protein, increased IGF-I

Increased muscle protein synthesis

Inhibition of apoptosis and promoting repair of damaged tissue

Promotion of ischaemic preconditioning

Less ischaemia/reperfusion damage

Johan Groeneveld et al. Critical Care 2002 6:102   doi:10.1186/cc1463